Democratic Republic of Congo: Measles vaccination makes the difference between life and death

During two weeks in December, Médecins Sans Frontières/Doctors Without Borders (MSF) carried out a measles vaccination campaign in Minova, Democratic Republic of Congo (DRC), that reached 90,887 young people. This was 20 percent more than the expected immunization target. Ana de la Osada, the medical focal point for the campaign, tells the story of MSF’s fight in Minova against measles, which is known locally as “suluby.”

By Ana de la Osada

Last September suluby reached the village of Karango. This spot in the region of Minova is perched in the mountains surrounding Lake Kivu, in the eastern Democratic Republic of Congo (DRC).

Suluby, better known elsewhere as measles, came down to Karango following the route that runs from the so-called Hauts Plateaux, the highlands just some kilometres away. It took advantage of the poor vaccination coverage that characterizes this area of the country to settle in comfortably and attack the most vulnerable — as usual. In early October, the visitor claimed the lives of four children of the village in only one week. They were all under five years old.

Members of the Médecins Sans Frontières/Doctors Without Borders (MSF) emergency team in the province of South Kivu moved quickly to respond, as the epidemic was spreading along the coast of Minova. Suluby hadn’t had its fill in Karango and appeared in other nearby towns such as Ruhunde and Nyamasasa.

MSF vs. measles: mass vaccination needed

MSF’s objective was clear: fight the epidemic. Mass vaccination was needed, but we also had to ensure free access to health centres and the hospital for the affected population in order to prevent and stop the complications that the measles virus can cause. Drug donations were made, health teams were supported and a system was established to refer the most serious cases to the hospital.

The difference between life and death for a child with measles can depend simply on whether their mother has money or not, for consultation and for treatment. Most health centres in this area do not offer free treatment, so unfortunately healthcare is not available to everyone.

'Suluby' shows no mercy on those with few resources

The first day MSF’s team arrived in Karango, we went to the health centre there to approach the staff. It was Saturday, the day of prenatal consultations, so we took the opportunity to talk to moms who were waiting their turn. When we told them about the mass vaccination campaign and the free treatment they started to applaud. One of them explained that she had lost the youngest two of her three children. Lack of moneys prevented her from taking her sick kids to the health centre and they died at home. Suluby shows no mercy on those with no resources.

In late October, we started to move around villages by the lake in the Minova area to ensure free health assistance and to encourage the community to join the vaccination campaign targeting children between 6 months and 15 years of age. Finally, the starting signal came on December 1, and we began the campaign. Our target during the next two weeks was to immunize 75,000 children. Good vaccination coverage is the best defence against the spread of measles, and that is precisely what we had to achieve.

Mothers standing for their children

On the dawn of the first morning, as we climbed to Karango, I thought of all those mothers with whom we talked,and all the children who received a visit from suluby, some with bad results. During the first three days we vaccinated all over the area of Karango: a total of 5,200 children. It was not easy to maintain order during the vaccination, but the mothers were very clear about their purpose and stayed standing for several hours, some from 6 am, eager to see their children receiving protection.

As I write this story, we are over halfway: 66,250 children have been vaccinated and we still have several days of intense work. Fatigue is increasing and each early start grows harder, but we are still standing. We calculate that by the end of the campaign we will exceed the target and reach 100,000 vaccinated children.

Suluby is already beginning to feel uncomfortable in the coastal area of Minova.

Measles can be fatal in children if untreated, but is very easy to prevent by vaccination. For decades, the DRC has suffered measles outbreaks, with a major resurgence of the disease since 2010. A retrospective studyconducted byEpicentre, the MSF epidemiological research centre, indicates that between 2010 and 2013 almost 300,000 measles cases were registered in the DRC and over 5,000 patients died. According to this report, case numbers fell by more than 20 per cent after the vaccination campaigns started.